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Uganda's Buvuma Islands

These islands are located on the northern shores of Uganda's Lake Victoria, Africa's
largest freshwater lake, but there is very little to drink.

Lush shorelines covered with tropical palms beneath an azure sky are the pictures
of paradise. But Uganda’s Buvuma Islands are no heaven on earth. The drinking water is filthy, HIV prevalence is near 90 percent,
there are few schools, fewer roads and no electrical and sewage systems. Too many
children die from cholera, dysentery and other water-borne diseases before they are
old enough to read.

“From a distance, the Buvuma Islands are scenic, sunny, tropical and pretty,” says
Terry Wolfer, a University of South Carolina professor who has journeyed there six times. “But
the reality really hits you when you step on land.”

Wolfer’s colleague Robin “Buz” Kloot agrees.

“It’s abject poverty on a scale that’s far beyond what we have in the United States,”
says Kloot, a researcher in Carolina's Earth Sciences and Resources Institute. “It’s very difficult to describe a place where people are too poor to have tin roofs
or cement walls or glass windows or even simple toilets in their homes.”

“The health issues from using or drinking unsafe water was a big threat to the lives
of the people on the island,” says Robert Wafula, vice president of Shepherd’s Heart International Ministry, a multinational charitable organization.

In 2006, Kloot journeyed to the islands for the first time to help deploy clean drinking
water systems. Once there, his mission changed from professional to personal. And
Kloot asked Wolfer, a professor in the College of Social Work with experience in community engagement, to help. Although unfamiliar with Africa
and water problems, Wolfer accompanied Kloot to Uganda the next summer.

With the help of the Ugandan staff members of Shepherd’s Heart, they deployed and
repaired water purification systems and conducted conferences to help village leaders better understand the risks of
water contamination and the cost of obtaining safe drinking water. But simply introducing
Western technology didn’t improve conditions. Technical breakdowns, logistical hurdles
and community strife plagued their efforts. “After a couple years, we realized that
our ‘fantastic American solutions’ were causing more problems,” Kloot says. “The villagers
became even more dependent on foreign aid.”

In preparation for their 2009 trip, Wolfer and Kloot wished for another solution,
a better way to help. Then Wolfer heard a report on National Public Radio focusing
on global sanitation. He and Kloot latched on to the work of Kamal Kar, the pioneer
of Community-Led Total Sanitation, a process used in poor, rural areas of the developing
world.

“That’s when we understood the villages didn’t have a water problem,” Kloot explains.
“The islands are located in the one of the world’s largest freshwater lakes. They
had an open defecation problem. Many villages have from 200 to 1,000 people and no
or only a handful of latrines.” Rainwater runoff washes the contaminants into Lake
Victoria, which is the source of the islanders' drinking water.

As they prepared to return, Kloot and Wolfer immersed themselves in learning about
Community-Led Total Sanitation, finding valuable resources in books and online. Once
back in Uganda, they demonstrated the system and coached Ugandans to lead it.

Community-Led Total Sanitation provokes communities to recognize and acknowledge the
problem of open defecation and to take actions to eliminate it. This is accomplished
by dramatically focusing on the conditions that inhabitants avoid discussing. The
intervention includes locating open defecation throughout the village, informally
mapping these areas, calculating the volume of feces, demonstrating how flies contaminate
food and proving that clear water isn’t necessarily safe drinking water. Facilitators
lead by asking questions throughout the intervention. Eventually, the villagers realize
they are unintentionally contaminating their own food and water.

“At this point, we say, ‘Thank you,’ and sit down,” Kloot says.

Agitated and concerned, the villagers immediately want to know when the team will
start building latrines and water systems. The facilitators reiterate their purpose
is to ask questions, not build latrines or give funding.

“Once the community realizes that the facilitators aren’t going to solve the problem
for them, most communities collaborate to find workable solutions,” Kloot says. “They
clean up contaminated areas, repair old outhouses and build new ones. The disgust
and embarrassment propels them to action.”

Kloot and Wolfer have trained staff members of Shepherd’s Heart International Ministries,
who continue the exercises after the two professors return to the United States. So
far, the team has conducted Community-Led Total Sanitation intervention in more than
20 villages, with mostly positive results.

“The program of water and sanitation has resulted in unity among local leaders and
community members as they have come together to help their villages escape the danger
diseases caused by open defecation,” says Wafula from Shepherd’s Heart. "Their involvement
has had a big impact and there is lots of evidence to show it. We commend them for
their heartfelt support and service to Shepherd’s Heart International Ministry and
the entire islands of Buvuma.”